Labor Induction in Low-risk Nulliparous Women at 39 Weeks of Gestation to Reduce Cesarean: A Randomized Trial of Induction Versus Expectant Management in France (FRENCH-ARRIVE)

What this Trial Is About

Researchers are evaluating whether elective labor induction at 39 weeks of gestation can reduce the rate of cesarean delivery in low-risk first-time pregnant women. This trial aims to confirm findings from a previous large U.S. study, the ARRIVE trial, in a French setting where cesarean rates and pregnancy characteristics differ. The study addresses concerns about whether routine induction at 39 weeks improves outcomes without increasing risks to mothers or babies. Participants are randomly assigned to one of two groups: elective labor induction between 39 weeks 0 days and 39 weeks 4 days using oxytocin and, if needed, cervical ripening techniques for an unfavorable cervix; or expectant management with standard follow-up until at least 41 weeks, with induction only if medically indicated or at 41 to 42 weeks per guidelines. The trial compares these approaches in terms of cesarean delivery rates and other maternal and neonatal outcomes. During the study, participants will have regular obstetrical care and monitoring according to French guidelines. Researchers will assess the incidence of cesarean sections as the primary outcome, along with various secondary outcomes including operative deliveries, maternal complications, and neonatal health measures. The study will continue until delivery, with follow-up through hospital discharge to evaluate safety and satisfaction. The total participation duration depends on gestational age at enrollment and delivery timing.

Labor Induction in Low-risk Nulliparous Women at 39 Weeks of Gestation to Reduce Cesarean: A Randomized Trial of Induction Versus Expectant Management in France (FRENCH-ARRIVE)